经皮髓核旋切术联合选择性脊神经根阻滞术治疗腰椎间盘突出症

EFFICACY OF PERCUTANEOUS DISC DECOMPRESSION WITH DECOMPRESSOR COMBINED WITH SELECTIVE SPINAL NERVE ROOT BLOCK ON LUMBAR DISC HERNIATION SYNDROME

目的:观察经皮Decompressor髓核旋切术联合选择性脊神经根阻滞术治疗腰椎间盘突出症的临床疗效和安全性。方法:选择60例包容性腰椎间盘突出症患者,随机分为A组30例,B组30例,分别应用国产康嘉公司生产的Decompressor髓核旋切器,在斜位X-线的引导下,经上关节突外缘穿刺入路,行髓核旋切腰椎间盘减压术。B组减压后联合应用选择性脊神经根阻滞术。用治疗前和治疗后三天、三个月VAS评分、直腿抬高试验及治疗优良率来评价临床疗效。结果:术后3天、2周、2月腰痛和腿痛评分、Oswestry评分B组均明显低于A组。亚组腿痛评分比较,术后3天、2周,B1组和B2组均明显低于A2组。结论:经皮Decompressor髓核旋切术联合选择性脊神经根阻滞术能快速而有效达到椎间盘减压并对神经根进行抗炎治疗,具有操作简便、损伤小、安全性高、疗效好。

Objective：To observe the safety and efficacy of percutaneous disc decompression with decompressor combined with selective spinal nerve root block（SNRB） on therapy of lumbar disc herniation（LDH） cases.Methods： 60 contained LDH patients were randomly divided into group A and B,each group contained 30 cases.Under the guidance of X-ray,group A was treated by disc decompression with decompressor through oblique angle puncturation.Group B was treated with decompression combined with SNRB.The effect of therapy was evaluated by observing VAS,straight leg raising（SLR） and goodexcellent rate of therapy before and 3 d,3 m after treatment.Results： At 3 d,2 w,2 m after treatment,there was statistically significant difference between groups A and B for leg pain scale,back pain scale,and oswestry disability scale.At 3 d,2 w,leg pain scale in subgroup B1 and B2 were lower than in subgroup A2.Conclusion： Decompressor with SNRB can get disc decompression quickly,effectively and safely and anti-inflammation in spinal nerve root.The procedure has the advantages of minimal invasion,simple manipulation,high safety,good efficacy.